Impact of Pretransplant Dialysis Modality on Posttransplant Outcomes: A Single-Center Experience

Objectives: It remains unclear whether posttransplant outcomes differ according to the pretransplant dialysis modality (peritoneal dialysis vs hemodialysis). Our aim was to assess posttransplant outcomes in patients with different predialysis modalities. Materials and Methods: Two thousand two hundred fifty- eight kidney recipients following up in Hamed Alessa Organ transplant center in Kuwait were included and divided into two groups according to pre-transplant dialysis modality: Group 1: those who received hemodialysis (HD) and group 2: those with peritoneal dialysis (PD). Demographics, pretransplant and posttransplant comorbidities, and patient and graft outcomes were studied. Results: There were 1956 patients on hemodialysis, and 302 patients were on peritoneal dialysis. Most were male patients (1456 vs 802 female patients), with comparable mean age ( P =.34). Chronic glomerulonephritis and diabetic nephropathy represented the most common original kidney disease before transplant (27.6% and 21.4%, respectively), with higher prevalence of glomerulonephritis in group 1 and diabetic nephropathy in group 2 (P =.001). The 2 groups were comparable with regard to immunosuppression (induction and maintenance) (P >.05). Posttransplant diabetes and hypertension were significantly higher in the hemodialysis group (P =.004 and P = 003, respectively). There was no significant difference between the 2 groups with regard to the graft outcome (P =.86). However, patient survival was significantly higher in the hemodialysis group (81.2% vs 64.4%). Conclusions: Compared with peritoneal dialysis, pretransplant hemodialysis is associated with better posttransplant patient survival despite no difference in the graft outcome. Diabetes-related complications could be attributed to such outcomes.